Osteoporosis is an enormous and continually growing public health problem. It leads to a large societal burden of bone pain, skeletal fracture, mortality and reduction in the quality of life. It affects men and women, and is increasing in incidence as the population ages. The annual cost of osteoporosis in the US is in the range of $30 billion in women alone. Osteoporosis can be primary (post-menopausal and senile osteoporosis) or can be secondary (for example in patients with rheumatic disease and emphysema on glucocorticoid therapy). To date, the mainstays of therapy have been directed at nutrition (calcium and vitamin D) and at preventing further bone loss through the blockade of osteoclastic bone resorption using a family of so called "anti-resorptive" drugs such as estrogen, selective estrogen receptor modulators, bisphosphonates and calcitonin. The recent and marked reduction in the use of estrogens following the release of the interim results of the Women's Health Initiative has left millions of women in the US "unprotected" against osteoporosis. In the past year, the FDA has approved parathyroid hormone, the first effective drug in a new class of skeletal anabolic agents. This event, together with rapid and extensive advances in the understanding of osteoblastic bone formation, with the explosion in identification of a myriad of new potential signaling molecules and transcriptional targets for anabolic skeletal agents, has revolutionized the field of osteoporosis therapy. The American Society for Bone and Mineral Research is the world's largest and premier society for the study and advancement of basic and clinical research in disorders relating to the skeleton. We have worked effectively in the past with the NIH in conference development. The considerations described above make it very clear that this is the time for senior thought leaders, mid-career investigators, and young investigators to meet in a small meeting setting, with NIH Institute staff, to review the current status of the field, to think collectively about the direction(s) in which the field should move, and to try to prioritize areas in which future clinical and basic research should be focused. Thus, the Aim of this proposal is to develop a meeting at the NIH Lister Hill center focused on advances in Skeletal Anabolic Agents and the Treatment of Osteoporosis.